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Thursday, September 25, 2014

Coverage of Latinos has surged, despite early struggles. "Overall, the percentage of Latinos ages 19 to 64 lacking health coverage fell from 36% to 23% between summer 2013 and spring 2014. That parallels a broader increase in coverage that has taken place....The overall uninsured rate for U.S. adults under 65 plummeted from 20% to 15% in the same period, according to the Commonwealth Fund....Other surveys have shown similar declines. But many of the health law's supporters were concerned that the expansion in coverage would not reach Latinos and other groups that have traditionally struggled to access regular medical care." Noam N. Levey in the Los Angeles Times.

ICYMI: The number of insurers providing Obamacare coverage is going up, too. Jason Millman in The Washington Post.

ACA — especially its Medicaid expansion — helps reduce hospitals' unpaid bills by $5.7B. "Millions more people with health insurance means fewer uninsured patients are coming through hospitals' doors. That means fewer costs from bad debt or charity care from people unable to pay their bills, which amounted to about $50 billion for the nation's hospitals in 2012....However, officials said they didn't specifically calculate how the lower costs from uncompensated care would show up in the premiums people pay for coverage. The reduction in uncompensated care is much greater in states that expanded their Medicaid programs under the Affordable Care Act, according to the new report." Jason Millman in The Washington Post.

ICYMI: Patients falling through the cracks as hospitals cut back on charity care. Alan Bavley in The Kansas City Star.

That finding could further increase pressure to expand Medicaid in GOP-governed states. "White House officials said they wanted to work with Republican governors on Medicaid, as they did with Gov. Tom Corbett of Pennsylvania, a Republican. They reached an agreement with Mr. Corbett last month on a plan to expand Medicaid by using federal funds to buy private health insurance for about 500,000 low-income people. The administration did not single out other states for special attention, but Florida, Georgia, North Carolina and Texas — all with Republican governors — are obvious candidates. Health policy experts estimate that 3.5 million people could gain coverage if those states expanded their Medicaid programs." Robert Pear in The New York Times.

Small-business SHOP coverage was hard to get last year. But it costs a bit less than insurance elsewhere. "Only a handful of states offered a fully functioning online small business exchange...during year one....But what about that second promise, of more affordable health plans? It appears, based on one new study, that the exchanges are delivering. Health plans available to small businesses on the law’s new health marketplaces are on average about 7 percent cheaper than comparable plans offered elsewhere, according to...a team of researchers at the National Opinion Research Center at the University of Chicago. For middle-tier plans, for instance, the disparity translates into about $220 in annual premium savings for plans purchased on the SHOP exchanges." J.D. Harrison in The Washington Post.

Firms' health costs rise at slower clip. Will that continue? "On one hand, the slowdown comes as a bit of a surprise....In addition, a new rule requiring many companies to provide comprehensive health plans were expected to increase costs for those that previously offered minimal or no insurance plans to their workers. However, early renewal of existing health plans and a string of delays to that so-called 'employer mandate' have allowed many firms to continue offering plans that do not comply with new minimum coverage requirements in the law. That has likely muted some of the rise in premiums we would otherwise see as employers shift to more robust, and thus more expensive, plans." J.D. Harrison in The Washington Post.

Analysis: Federal exchange website costs over $2B. "Spending for healthcare.gov and related programs, including at...other federal agencies, exceeds cost estimates provided by the Obama administration, the analysis found. The government’s most recent estimate, limited to spending on computer systems by the agency that runs the site, through February, is $834 million....The construction of healthcare.gov involved 60 companies, supervised by employees of the Centers for Medicare and Medicaid Services instead of a lead contractor....The project was marked by infighting among the contractors, CMS officials and top officials at HHS, the Cabinet-level department that oversees CMS." Alex Wayne in Bloomberg.

Other health care reads:

What the religious right thinks of Republicans' new birth-control platform. Sophie Novack in National Journal.

White House issues new regulations for dangerous biological research. Donald G. McNeil Jr. in The New York Times.

KLEIN: In conservative media, Obamacare is a disaster. Not in the real world. "Obamacare isn't by any means a perfect law and not everything in it is going right....On the whole, though, costs are lower than expected, enrollment is higher than expected, the number of insurers participating in the exchanges is increasing, and more states are joining the Medicaid expansion. Millions of people have insurance who didn't have it before. The law is working. But a lot of the people who are convinced Obamacare is a disaster will never know that, because the voices they trust will never tell them." Ezra Klein in Vox.

CARROLL: Medicaid expansion gives poor reason to say 'no thanks.' "While Medicaid...has used cost-sharing mechanisms for some time, it has been prohibited from asking people to pay premiums. In the last couple of years, federal regulators have started lifting that prohibition, which is likely to lead to some negative consequences. Cost-sharing mechanisms are specifically intended to encourage people to consume less health care. As I have discussed in previous articles, a large body of research shows that increased cost-sharing leads to decreased utilization. The more you ask people to pay at the point of care, out of their own pockets, the less likely they are to obtain it." Aaron E. Carroll in The New York Times.